EMS Agencies Adapted to Persistent Medication Shortages
Providers are utilizing substitute drugs and quality reviews to maintain care during ongoing national medication supply chain issues.
Updated on Oct. 12, 2026 in Asthma
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EMS agencies across the U.S. have been forced to adjust drug box inventories and packaging as medication shortages persist. Agencies now rely on alternative medications and quality improvement studies to ensure patient outcomes remain consistent.
Why it matters
Frequent inventory adjustments and drug substitutions are necessary to maintain emergency care standards. Ongoing shortages require providers to remain flexible with clinical protocols to account for drug unavailability.
A quality improvement study of 109 adenosine administrations yielded a 64.2% success rate, while 11% of patients required electrical cardioversion following the intervention. Providers also utilize alternatives like droperidol and promethazine when ondansetron is unavailable.
The players
James Augustine
He is a medical director in Southwest Florida and a presenter at the 2026 EMS World Expo.
The details
Agencies are managing shortages by creating secondary medication lists and adjusting drug concentrations to maintain clinical capabilities. These strategies ensure that cardiac patients continue to receive necessary care through combinations of supportive care, chemicals, and electricity.
Timeline
James Augustine presented on medication management at the EMS World Expo in 2026.
The EMS1 Medication Matters Week takes place from Oct 12-16, 2026.
Health Landscape
This approach to medication management reflects a broader push within emergency medicine to institutionalize quality improvement cycles as a response to systemic supply chain fragility. These adaptations highlight how modern EMS must integrate data-driven feedback to sustain patient care when standard pharmacological tools are unavailable.
Patients may notice changes in the types of drugs administered during emergency transport as agencies switch to available alternatives. These clinical adjustments aim to maintain high-quality outcomes even when primary medications are in short supply.
The takeaway
Maintaining emergency care during shortages relies on continuous clinical review and the flexible use of alternative drug protocols. Providers must focus on data-driven efficacy metrics to ensure that substitutions remain safe and effective for patients.
Further reading
For more information on respiratory and emergency clinical standards, visit Asthma.
Source note: This article includes information reported by EMS1.
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